“As the last in a series of 14 annual reports, Health Indicators 2013 provides an overview of the joint CIHI-Statistics Canada Health Indicators reporting project and describes CIHI’s new program of work in health system performance reporting. This publication also contains the most recently available health indicators data and features an In Focus section that highlights the expanded reporting of health indicators by socio-economic status.”Read Full Post | Make a Comment ( Comments Off on Health Indicators 2013 – Canadian Institute for Health Information (CIHI) – 23 May 2013 )
Public Health Outcomes Framework 2013 to 2016 and technical updates – Department of Health [England] – 1 May 2013
Public Health Outcomes Framework 2013 to 2016 and technical updates – Department of Health [England] – 1 May 2013Read Full Post | Make a Comment ( Comments Off on Public Health Outcomes Framework 2013 to 2016 and technical updates – Department of Health [England] – 1 May 2013 )
NHS in numbers: key charts – Nuffield Trust – April 2013
“This series of interactive charts illustrates key data on health care spending, hospital activity, performance, prescribing, and NHS staffing and other resources, for England and the rest of the UK where comparable data is available.”Read Full Post | Make a Comment ( Comments Off on NHS in numbers: key charts – Nuffield Trust – April 2013 )
Development of Quality Indicators for the Home and Community-Based Services Population: Technical Report – AHRQ Quality Indicators – June 2012
Prepared by: Ellen Schultz, Sheryl M. Davies, Kathryn M. McDonald, Center for Primary Care and Outcomes Research, Stanford University. This project was funded by a contract from the Agency for Healthcare Research and Quality
These quality indicators (QIs) are intended to reflect the health and well-being of beneficiaries receiving home and community-based services (HCBS) through state Medicaid programs. The indicators focus on the well being of HCBS beneficiaries as reflected by potentially preventable hospitalizations. These include hospitalizations for specific conditions associated with chronic disease exacerbation and progression as well as poor access to care and support services.”Read Full Post | Make a Comment ( Comments Off on Development of Quality Indicators for the Home and Community-Based Services Population: Technical Report – AHRQ Quality Indicators – June 2012 )
Managing the performance of the health care system – FlagPost – 6 August 2012Read Full Post | Make a Comment ( Comments Off on Managing the performance of the health care system – FlagPost – 6 August 2012 )
Measuring Health System Progress in Reducing Mortality from Noncommunicable Diseases – RAND – May 2012
by Soeren Mattke, Jack C. Chow
“Noncommunicable diseases (NCDs) place a heavy burden on developing countries, whose relatively recent adoption of Western-style health behaviors and lifestyle choices has led to increased prevalence of risk factors for NCDs over the past decade. NCDs are compounding the burden of infectious disease on health systems in those countries. In response, the World Health Organization (WHO) has launched several risk reduction initiatives. WHO is drafting a monitoring framework and voluntary targets as the basis for a consultation process with member states. However, the indicators and targets that a global consultation process will produce will inevitably provide high-level, aggregated information, such as progress toward reducing premature NCD mortality. Regional and national decisionmakers and planners, on the other hand, will need more proximal and granular information to track progress toward high-level goals and will be constrained by the resources and demands in their respective jurisdictions. The relative importance of different risk factors and manifest NCDs differs across countries, and so do health systems’ capabilities and resources. Thus, national and regional decisionmakers will need: (1) a comprehensive set of indicators to guide on-the-ground prioritization decisions and track progress toward high-level targets and (2) actionable data to predict the impact of changes in proximal indicators on high-level targets. As a first step, this occasional paper outlines a roadmap toward a comprehensive system for national and regional decisionmakers to (1) track progress toward the key WHO goal of reducing NCD mortality by 25 percent by 2025 and (2) prioritize resources and interventions to achieve that goal.”Read Full Post | Make a Comment ( Comments Off on Measuring Health System Progress in Reducing Mortality from Noncommunicable Diseases – RAND – May 2012 )
Measuring and reporting on health system performance in Canada: Opportunities for improvement – Health Council of Canada – May 2012
“The paper highlights the need for governments to set clear policy goals with both measurable health outcomes and supporting health indicators in order to hold health system leaders accountable for performance. The paper provides recommendations to governments, at the same time highlighting innovative practices across Canada and in the United Kingdom and Australia that can provide a way forward.”Read Full Post | Make a Comment ( Comments Off on Measuring and reporting on health system performance in Canada: Opportunities for improvement – Health Council of Canada – May 2012 )
Health system performance comparison: an agenda for policy, information and research – WHO on behalf of the European Observatory on Health Systems and Policies – 2012
by Peter C. Smith, Irene Papanicolas
• International health system performance comparisons have the potential to provide a rich source of evidence as well as policy influence.
• Country comparisons that are not conducted with properly validated measures and unbiased policy interpretations may prompt adverse policy impacts and so caution is required in the selection of indicators, the methodologies used, and the interpretations made.”
“The Canadian Hospital Reporting Project (CHRP) is a national quality improvement initiative from the Canadian Institute for Health Information (CIHI). CHRP’s web-based, interactive tool gives hospital decision-makers, policy-makers and Canadians access to indicator results for more than 600 facilities from every province and territory in Canada.
CIHI selected 21 clinical and 9 financial indicators for CHRP, based on their relevance to performance measurement and quality improvement. The selected indicators measure:
Appropriateness of care;
These indicators were chosen after reviewing existing hospital performance indicators and collaborating with experts in the field. The goal of CHRP is to foster quality improvement, learning and action.”
… continues on the siteRead Full Post | Make a Comment ( Comments Off on Canadian Hospital Reporting Project (CHRP) – Canadian Institute for Health Information )
AHRQ Quality Indicators™ Toolkit for Hospitals [US] – March 2012
“AHRQ QI Toolkit: How to Improve Hospital Quality and Safety.
Improving Performance on the AHRQ Quality Indicators
This toolkit is designed to help your hospital understand the Quality Indicators (QIs) from the Agency for Healthcare Research and Quality (AHRQ), and support your use of them to successfully improve quality and patient safety in your hospital. The toolkit is a general guide to using improvement methods, with a particular focus on the QIs. It focuses on the 17 Patient Safety Indicators (PSIs) and the 28 Inpatient Quality Indicators (IQIs).”Read Full Post | Make a Comment ( Comments Off on AHRQ Quality Indicators™ Toolkit for Hospitals [US] – March 2012 )
NHS Outcomes Framework indicators – Autumn 2011 release, England – 16 December 2011
The NHS Outcomes Framework indicators form part of the NHS Outcomes Framework, which will:
1.provide national level accountability for the outcomes the NHS delivers
2.drive transparency, quality improvement and outcome measurement throughout the NHS.”
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An Evaluation of the Use of Performance Measures in Health Care – RAND Health Technical Report – 2011
“NQF [National Quality Forum] engaged the RAND Corporation to conduct an independent examination of the use of performance measures, with particular interest in the use of NQF-endorsed measures. The goal was to better understand
• the current state of performance measure use across the broad spectrum of end-user types
• areas in which gaps in measures exist that hinder the end users’ ability to apply measures to support the achievement of their desired goals
• how the larger measurement enterprise (i.e., measure developers, measure endorsers, foundations and government agencies that support measure development and implementation) might better support the use of performance measures.”
National Scorecard on U.S. Health System Performance, 2011 – The Commonwealth Fund – 18 October 2011
The National Scorecard on U.S. Health System Performance, 2011, updates a series of comprehensive assessments of U.S. population health and health care quality, access, efficiency, and equity. It finds substantial improvement on quality-of-care indicators that have been the focus of public reporting and collaborative initiatives. However, U.S. health system performance continues to fall far short of what is attainable, especially given the enormity of public and private resources devoted nationally to health. Across 42 performance indicators, the U.S. achieves a total score of 64 out of a possible 100, when comparing national rates with domestic and international benchmarks. Overall, the U.S. failed to improve relative to these benchmarks, which in many cases rose. Costs were up sharply, access to care deteriorated, health system efficiency remained low, disparities persisted, and health outcomes failed to keep pace with benchmarks. The Affordable Care Act targets many of the gaps identified by the Scorecard.”
How is the NHS performing? October 2011 quarterly monitoring report – King’s Fund – 14 October 2011
John Appleby, James Thompson, Amy Galea
Many NHS hospitals will struggle to deliver productivity improvements essential to maintaining quality and avoiding significant cuts to services, according to our latest quarterly monitoring report.
This is the third quarterly monitoring report produced by the Fund as we aim to provide a regular update on how the NHS is coping as it grapples with the evolving reform agenda as well as the more significant challenge of making radical improvements in productivity. It complements our NHS health check prezi and is a continuation of work that we have done historically to assess, analyse and report on the performance of the NHS.”Read Full Post | Make a Comment ( Comments Off on How is the NHS performing? October 2011 quarterly monitoring report – King’s Fund – 14 October 2011 )
Methodological Considerations in Generating Provider Performance Scores for Use in Public Reporting: A Guide for Community Quality Collaboratives – AHRQ – September 2011
“This [white] paper is intended for use by Chartered Value Exchanges (CVEs), community collaboratives, and other organizations interested in creating public reports on the performance of health care providers in their communities. It addresses the issue of inconsistent reports based on the same data and identifies the key methodological decision points that precede publication of a performance report.”
Friedberg MW, Damberg CL. Methodological Considerations in Generating Provider Performance Scores for Use in Public Reporting: A Guide for Community Quality Collaboratives. AHRQ Publication No. 11-0093, September 2011. Prepared by RAND Corporation under Contract No. HHSA290200810037C. Agency for Healthcare Research and Quality, Rockville, MD.
How This Paper Is Organized
Overarching Methodological Issue: Performance Misclassification
Decisions Encountered During Key Task Number 1: Negotiating Consensus on Goals and “Value Judgments” of Performance Reporting
Decisions Encountered During Key Task Number 2: Selecting the Measures That Will Be Used To Evaluate Provider Performance
Decisions Encountered During Key Task Number 3: Identifying Data Sources and Aggregating Performance Data
Decisions Encountered During Key Task Number 4: Checking Data Quality and Completeness
Decisions Encountered During Key Task Number 5: Computing Provider-Level Performance Scores
Decisions Encountered During Key Task Number 6: Creating Performance Reports
Summary of Methodological Decisions Made by a Sample of CVE Stakeholders
Appendix 1: Validity and Systematic Performance Misclassification
Appendix 2: Performance Misclassification Due to Chance
Development and Implementation of Key Performance Indicators to Support the Outcomes and Programs Framework – Australian National Audit Office – 8 September 2011
Audit Report No.5 2011–12 Performance Audit
ISBN 0 642 81210 1
“The objective of this audit was to assess how effectively entities had developed and implemented appropriate KPIs to support stated program objectives. To address the audit objective, the ANAO:
• undertook a desktop review of the published effectiveness KPIs for 89 programs across 50 Financial Management and Accountability Act and Commonwealth Authorities and Companies Act entities within the General Government Sector (GGS)12;
• supplemented this desktop review with more detailed analysis of four entities—the Australian Customs and Border Protection Service (Customs); Fair Work Australia (FWA); the National Film and Sound Archive (NFSA); and the Department of Resources, Energy and Tourism (RET)—including the reporting of performance in each entity’s annual report; and
• assessed the role of Finance in administering the Outcomes and Programs Framework, including the preparation of guidance material for entities.”
Welcome to Value for Money (VfM) indicators
“Value for Money (VfM) Indicators is the leading benchmarking tool for assessing value for money in the public sector. HM Treasury specifically recommends collecting and reporting against indicators, for organisations with more than 250 employees.
VfM Indicators has the widest coverage of back office functions, which are under scrutiny in many parts of the public sector at present. You can assess performance of finance, human resources, information and communication technology, estate management, procurement, legal functions and communications.
VfM Indicators will assess your organisation’s performance, and pinpoint its strengths and weaknesses, helping you to make more informed decisions on budget and improvement. The system also provides you with solid, data-related evidence to support decisions. “
“The Fraser Institute’s Hospital Report Card: British Columbia 2011 is constructed in order to contribute to the improvement of inpatient care in British Columbia by providing hospital-specific information about quality of service directly to patients and to the general public. It aims to promote greater accountability within hospitals, thereby stimulating improved performance through independent and objective measurement. This is an interactive web-based report card, and all results and accompanying information are available at our interactive website.” … continues on the siteRead Full Post | Make a Comment ( None so far )
Victorian Health Services Performance – launched 30 June 2011
“The Victorian Health Services Performance website provides statistical information about Victoria’s public hospitals and health services.
You will find information about the hospital system and performance reports on individual hospital and health services as well as statewide data for:
•Quality and Safety
This website is the first step towards increasing the transparency and breadth of health service performance information available to the Victorian public.
Activity and performance information on this site will be updated quarterly and the range of data and information available will be expanded in the near future.”
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Delivery System Reform Tracking: A Framework for Understanding Change – Commonwealth Fund – 2 June 2011
The health care delivery system is changing rapidly, with providers forming patient-centered medical homes and exploring the creation of accountable care organizations. Enactment of the Affordable Care Act will likely accelerate these changes. Significant delivery system reforms will simultaneously affect the structures, capabilities, incentives, and outcomes of the delivery system. With so many changes taking place at once, there is a need for a new tool to track progress at the community level. Many of the necessary data elements for a delivery system reform tracking tool are already being collected in various places and by different stakeholders. The authors propose that all elements be brought together in a unified whole to create a detailed picture of delivery system change. This brief provides a rationale for creating such a tool and presents a framework for doing so.”
“New data is now available on the performance of Victorian hospitals not previously available within the public domain.
Publication of this data confirms steps are being taken to increase the transparency and breadth of public Health Services performance reporting and to make more information available to the Victorian public.
The reports contain comprehensive information on Health Service Performance including information on Hospital Bypass and Hospital Early Warning System, Patient Transfer Times and Elective Surgery.
In future months, a wider range of information will be reported and made available through a new and dedicated website to provide information about health services activity and performance.” … continues on the siteRead Full Post | Make a Comment ( None so far )
“Australian Health Ministers met in Melbourne today and reached in principle agreement on legislation to establish the National Health Performance Authority as the next stage of national health reform.” … continues on the siteRead Full Post | Make a Comment ( None so far )
Health Indicators 2011 – Canadian Institute for Health Information and Statistics Canada – 8 June 2011
Health Indicators 2011 – Canadian Institute for Health Information and Statistics Canada – 8 June 2011
Extract from the Executive summary:
“Health Indicators 2011, the 12th in a series of annual flagship reports, presents the most recent data from the Canadian Institute for Health Information (CIHI) and Statistics Canada on a broad range of measures. This report seeks to answer two fundamental questions: “How healthy are Canadians?” and “How healthy is the Canadian health system?”
The indicators were selected based on directions provided at three National Consensus Conferences on Health Indicators.1–3 Each indicator falls into one of the five dimensions of the internationally recognized4 Health Indicator Framework:
• Health status—provides insight into the health of Canadians, including well-being, human function and selected health conditions.
• Non-medical determinants of health—reflects factors outside of the health system that affect health.
• Health system performance—provides insight into the quality of health services, including accessibility, appropriateness, effectiveness and patient safety.
• Community and health system characteristics—provides useful contextual information, rather than direct measures of health status or quality of care.
• Equity—provides insight into health disparities.
In addition to presenting the latest indicator results, this year’s report introduces three new indicators that are focused on mental health. In Canada, as in many countries, mental illnesses are among the 20 leading causes of disability5 and are associated with death by suicide.6–8 Seventy percent of mental illnesses develop at a young age, they often persist over time and they affect people of all cultures and socio-economic status.8–11 They are also costly to the health system. In Canada, when taking into account costs associated with the reduction in health-related quality of life, loss of productivity in the workplace and direct costs of mental health services and supports, the economic impact of mental illnesses was estimated to be $52 billion in 2006 by the Institute of Health Economics.”Read Full Post | Make a Comment ( None so far )
Transforming Community Services: Demonstrating and Measuring Achievement: Community Indicators for Quality Improvement – UK – 14 April 2011
Author: Department of Health
“This document introduces 43 indicators for quality improvement for voluntary, local use in a community setting. These carefully chosen quality indicators will assist local service improvement and help to raise the standard of care delivered to patients and communities.”Read Full Post | Make a Comment ( None so far )
The NHS Performance Framework: Implementation guidance – 2011/12 – Department of Health – 14 April 2011
The NHS Performance Framework: Implementation guidance – 2011/12 – Department of Health – 14 April 2011
“To support the application of the NHS Performance Framework; to inform Strategic Health Authorities (SHAs) as the regional system managers and Primary Care Trusts (PCTs) as the local commissioners of NHS services of when they should intervene to address poor performance; and to inform NHS organisations of the criteria against which their performance will be assessed.”Read Full Post | Make a Comment ( None so far )
Author: Department of Health
Following a three month consultation period, this is the final version of the acute oncology measures for inclusion in the Manual of Cancer Services 2008.
Manual for Cancer Services: Network Service User Partnership Group Measures – UK – 7 April 2011
Author: Department of Health
Following a three month consultation period, this is the final version of the Network Service User Partnership Group Measures for inclusion in the Manual of Cancer Services 2008.
“The Resource for Indicator Standards (RIS) is an online catalogue of the technical documentation for health-related indicators. These indicators are used by the Ministry of Health and Long-Term Care (MOHLTC) or Local Health Integration Networks to monitor health care system performance. Indicators in RIS are documented in a standard way to promote appropriate use, comparison, and analysis. “Read Full Post | Make a Comment ( None so far )
Selecting Quality and Resource Use Measures: A Decision Guide for Community Quality Collaboratives – AHRQ – 2010
AHRQ = US Agency for Healthcare Research and Quality
“Selecting quality of care and resource use measures is an important and challenging task for organizations striving to improve the quality of health care in their communities. This Decision Guide is designed to inform readers about the most critical issues to consider when selecting and adopting such performance measures.”
AHRQ Publication No. 09(10)-0073
List of Stakeholder Questions
Foreword: Improving Quality One Community at a Time
Part I. Introduction to Performance Data
Part II. Introduction to Measures of Quality
Part III. Introduction to Resource Use/Efficiency Measures
Part IV. Selecting Quality and Resource Use Measures
Part V. Interpreting Quality and Resource Use Measures
Appendix A. Measure Evaluation Framework
Appendix B. Contacts for Chartered Value Exchanges
Appendix C. Glossary
Health care systems: efficiency and institutions – OECD – 19 May 2010
“This paper presents a set of indicators to assess health care system performance. It also presents new comparative data on health care policies and institutions for OECD countries. This set of indicators allows the empirical characterisation of health care systems and the identification of groups of countries sharing similar health institutions. It also helps to uncover strengths and weaknesses of each country’s health care system and assessing the scope for improving value-for-money. The empirical analysis suggests that there is room in all countries surveyed to improve the effectiveness of health care spending; there is no health care system that performs systematically better in delivering cost-effective health care – big-bang reforms are therefore not warranted; increasing the coherence of policy settings, by adopting best policy practices within a similar system and borrowing the most appropriate elements from other systems will likely be more practical and effective to raise health care spending efficiency.”Read Full Post | Make a Comment ( None so far )
Innovative Software Cuts Costs and Time for States to Report Hospital Quality Information to the Public – AHRQ – 3 June 2010
Innovative Software Cuts Costs and Time for States to Report Hospital Quality Information to the Public
Press Release Date: June 3, 2010
“The Department of Health & Human Services’ (HHS’s) Agency for Healthcare Research and Quality (AHRQ) today unveiled MONAHRQ—My Own Network Powered by AHRQ—a free, MS® Windows®-based software application that significantly reduces the cost and time a State, hospital or other organization would need to spend to compile, analyze and post data on quality of hospital care, its cost and how that care is used. MONAHRQ allows users to create a customized Web site with data that can be used for internal quality improvement or reporting quality information to the public.
The cost of creating a Web site with this data is estimated to be $300,000 or more, and the time required could be a year, according to States that tested MONAHRQ as it was being developed. With MONAHRQ, that time can be cut to a few days. Currently, many States require that quality data be reported publicly and other States are considering doing so. For example, the Hawaii Health Information Corporation, which tested MONAHRQ, plans to recommend that they use the AHRQ software application for that purpose.
A State, or other organization, referred to as the host user, can download MONAHRQ from AHRQ’s Web site at http://monahrq.ahrq.gov and enter its own hospital administrative data, which includes such elements as patient characteristics, diagnoses, procedures, health insurance type and charges. MONAHRQ processes that information and then creates a Web site that the host user can customize by selecting a specific color scheme, inserting logos and using other features.
“Building on AHRQ’s strong track record of developing innovative quality indicators and hospital reporting tools, MONAHRQ will revolutionize how States and others report data publicly or use it to improve health care quality,” said AHRQ Director Carolyn M. Clancy, M.D. “MONAHRQ also will help consumers make informed decisions about hospital care because they will have access to state-of-the art information.”
A Web site created using MONAHRQ will provide information in four areas:
Quality of care for specific hospitals—provides information about patient safety, patient deaths in the hospital and other quality-related issues to answer questions such as, “Which hospitals have the lowest mortality rates after coronary bypass surgery?”
Provision of services by hospital for health conditions and procedures—provides information about the number of patient discharges, charges, costs and length of hospitalizations for specific hospitals to answer questions such as, “Which hospitals perform the largest numbers of hip replacement surgeries? And what is the cost?”
Potentially avoidable hospitalizations—creates maps of county-by-county rates for potentially avoidable hospitalizations to answer questions such as, “Which counties have the highest rates of hospitalization for uncontrolled diabetes? And how much could be saved if these rates were reduced?”
Rates of health conditions and procedures—provides information about the prevalence of diseases or medical procedures through maps of county-by-county rates for selected conditions and procedures to answer questions such as, “Which counties have the highest rates of lung cancer?” ”
…continues on the site
Canadian MIS Database (CMDB), Hospital Financial Performance Indicators, 1999-2000 to 2008-2009 – published 13 May 2010
Canadian Institute for Health Information Pages: 23
“Understanding how hospital financial information changes over time is critical to evaluating hospital performance. Canadian MIS Database, Hospital Financial Performance Indicators, 1999-2000 to 2008-2009 reports on regional level hospital performance using 2008-2009 data. This report is an update to information previously reported in Canadian MIS Database, Hospital Financial Performance Indicators 1999-2000 to 2008-2009. CIHI will continue to monitor the ongoing feasibility of using data from the CMDB in the future to produce and report any additional indicators
The indicators that are used in this report are:
Administrative Expense as a Percentage of Total Expense
Information Systems as a Percentage of Total Expense
Cost per Weighted Case
Unit-producing Personnel Worked Hours for Patient Care Functional Centres as a Percentage of Total Worked Hours
Nursing Inpatient Services Unit-producing Personnel Worked Hours per Weighted Case
Diagnostic Services Unit-producing Personnel Worked Hours per Weighted Case
Clinical Laboratory Unit-producing Personnel Worked Hours per Weighted Case
Pharmacy Unit-producing Personnel Worked Hours per Weighted Case
Average Age of Equipment ”